Nursing 612 API Adult Gerontology at St Thomas University
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Free Nursing 612 API Adult Gerontology at St Thomas University Questions
The nurse practitioner implements an approved plan of care proposed in the National Asthma Education and Prevention Program Expert Panel Report-3 (NAEPP-EPR-3) for an older adult patient with asthma. This includes which of the following? Select all that apply.
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Monitoring of appropriate use of medications.
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Patient, family, and professional education so as to create a partnership in asthma management.
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Control of comorbidities.
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Use of a standardized asthma care plan
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Completion of the assessment and monitoring, as this is not an ongoing process.
Explanation
The Correct Answers are:
A. Monitoring of appropriate use of medications, B. Patient, family, and professional education so as to create a partnership in asthma management, C. Control of comorbidities, and D. Use of a standardized asthma care plan.
Detailed Explanations:
A. Monitoring of appropriate use of medications:
Regular monitoring ensures proper use of both controller and rescue medications, promoting adherence and preventing overuse or underuse that could worsen symptoms or cause side effects.
B. Patient, family, and professional education so as to create a partnership in asthma management:
The NAEPP emphasizes a collaborative approach involving patients, families, and healthcare providers. Education enhances understanding of triggers, medications, and self-management techniques.
C. Control of comorbidities:
Managing related conditions such as allergic rhinitis, GERD, and obesity improves asthma control and reduces exacerbations.
D. Use of a standardized asthma care plan:
A written, evidence-based asthma action plan guides daily management and provides instructions for handling worsening symptoms or attacks.
Patient education is very important for individuals who have AAA. The patient and their family should be taught the importance of follow-up and the management of which of the following? Select all that apply.
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Chondromalacia
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Pain
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Smoking
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Hypertension
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Hypercholesterolemia
Explanation
The Correct Answers are:
B. Pain, C. Smoking, D. Hypertension, and E. Hypercholesterolemia.
Detailed Explanations:
B. Pain:
Pain may indicate aneurysm expansion or impending rupture. Patients should be taught to report new, persistent, or severe abdominal or back pain immediately, as this may signify a medical emergency.
C. Smoking:
Smoking accelerates atherosclerosis, damages vascular walls, and increases aneurysm growth and rupture risk. Complete smoking cessation is crucial to slow aneurysm progression and improve vascular health.
D. Hypertension:
Uncontrolled blood pressure raises wall tension in the aorta, significantly increasing the risk of aneurysm rupture. Strict blood pressure control through medication and lifestyle modification is essential for safety.
E. Hypercholesterolemia:
Elevated cholesterol contributes to atherosclerosis, the underlying cause of most abdominal aortic aneurysms. Managing cholesterol through diet, exercise, and medication helps reduce vascular inflammation and aneurysm progression.
Treatment to slow the progression of PAD should include which of the following? Select all that apply.
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Conservative
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Surgical
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Pharmacological
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Heat
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Immobilization
Explanation
The Correct Answers are:
A. Conservative, B. Surgical, and C. Pharmacological.
Detailed Explanations:
A. Conservative:
Conservative management is the first-line approach for peripheral arterial disease (PAD). It includes lifestyle modifications such as smoking cessation, regular exercise (especially walking programs), weight control, and a heart-healthy diet. These interventions improve circulation and slow disease progression.
B. Surgical:
Surgical or interventional procedures, such as angioplasty, stent placement, or bypass grafting, are used in severe cases to restore adequate blood flow when conservative and medical therapies are insufficient.
C. Pharmacological:
Medications such as antiplatelet agents (aspirin or clopidogrel), statins, and cilostazol help improve blood flow, prevent clot formation, and reduce atherosclerotic progression.
Ms. Alma, 69 years old, seeks medical advice because she is having trouble breathing. She is experiencing dyspnea, chronic cough with sputum production, and decreased activity tolerance. The nurse practitioner suggests which of the following? Select all that apply.
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The body contains less water as you age, and the mucus begins to dry out.
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As you get older, the tissue in your lungs is not as flexible to aid in exhaling.
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The muscles that help to inhale become stronger as you age.
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The cough reflex is normal, but the mucus is too thick.
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As you get older, there is an increase in the exchange of gases between the lungs and the blood vessels.
Explanation
The Correct Answers are:
A. The body contains less water as you age, and the mucus begins to dry out; B. As you get older, the tissue in your lungs is not as flexible to aid in exhaling; and D. The cough reflex is normal, but the mucus is too thick.
Detailed Explanations:
A. The body contains less water as you age, and the mucus begins to dry out:
With aging, total body water decreases, leading to thicker mucus that is harder to expel. This contributes to chronic cough and ineffective airway clearance.
B. As you get older, the tissue in your lungs is not as flexible to aid in exhaling:
Elastic tissue in the lungs loses its flexibility with age, causing reduced recoil and air trapping. This makes it harder to exhale completely and leads to shortness of breath.
D. The cough reflex is normal, but the mucus is too thick:
Although the cough reflex remains intact, thicker mucus is more difficult to clear, reducing the effectiveness of coughing and increasing the risk of airway obstruction or infection.
Ms. Alma, 69 years old, seeks medical advice because she is having trouble breathing. She is experiencing dyspnea, chronic cough with sputum production, decreased activity tolerance, and wheezing. She states that she had not been near anyone with any upper respiratory infections and wonders why this is happening. The nurse practitioner asks which of the following questions? Select all that apply.
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Have you ever worked in a factory or foundry?
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Have you ever smoked cigarettes?
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Have your symptoms increased as you've gotten older?
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How long have you experienced these symptoms?
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Do you have any past history of respiratory difficulties?
Explanation
The Correct Answers are:
A. Have you ever worked in a factory or foundry?, B. Have you ever smoked cigarettes?, C. Have your symptoms increased as you've gotten older?, D. How long have you experienced these symptoms?, and E. Do you have any past history of respiratory difficulties?
Detailed Explanations:
A. Have you ever worked in a factory or foundry?
Occupational exposure to dust, chemicals, and fumes is a significant risk factor for chronic obstructive pulmonary disease (COPD) and other chronic lung conditions.
B. Have you ever smoked cigarettes?
Smoking is the leading cause of COPD and chronic bronchitis. Assessing smoking history helps establish the most likely etiology for her symptoms.
C. Have your symptoms increased as you've gotten older?
Progressive worsening with age supports a chronic disease process such as COPD, rather than an acute infection.
D. How long have you experienced these symptoms?
Duration helps distinguish between acute respiratory infections and chronic respiratory diseases. Longstanding symptoms indicate a chronic underlying problem.
E. Do you have any past history of respiratory difficulties?
A prior history of respiratory illnesses such as asthma, bronchitis, or pneumonia provides context for current symptoms and helps guide diagnosis and management.
John is 80 years old and is experiencing the following: weight gain, tachycardia, neck vein distention, and cognitive impairment. The nurse practitioner assesses for which of the following to support a diagnosis of heart failure? Select all that apply.
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Laterally displaced point of maximum impulse of apical pulse.
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Asymptomatic
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Rales in bilateral lower lobes not due to atelectasis or ascites.
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Increase in appetite and alertness.
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Functional impairment.
Explanation
The Correct Answers are:
A. Laterally displaced point of maximum impulse of apical pulse, C. Rales in bilateral lower lobes not due to atelectasis or ascites, and E. Functional impairment.
Detailed Explanations:
A. Laterally displaced point of maximum impulse of apical pulse:
A laterally displaced PMI occurs when the left ventricle enlarges due to volume overload or decreased contractility—both common findings in heart failure. It indicates ventricular dilation.
C. Rales in bilateral lower lobes not due to atelectasis or ascites:
Crackles (rales) in the lung bases result from pulmonary congestion and fluid accumulation caused by left-sided heart failure. These are hallmark findings indicating poor cardiac output and pulmonary venous hypertension.
E. Functional impairment:
Heart failure decreases exercise tolerance and daily functioning due to fatigue, dyspnea, and poor perfusion. This functional decline is a key clinical indicator, especially in older adults.
Sam is 64 years old and has been feeling weak, lightheaded, and slightly nauseous. He goes to the urgent care center where the nurse practitioner initiates an assessment. Which of the following suggest an arrhythmia? Select all that apply.
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Palpitations and syncope.
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Chest x-ray showing an increased size of the left atria.
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Lack of family history of any acute heart conditions.
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History of alcohol drinking.
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No history of heart pounding, racing, or skipping beats.
Explanation
The Correct Answers are:
A. Palpitations and syncope and D. History of alcohol drinking.
Detailed Explanations:
A. Palpitations and syncope:
These are classic symptoms of an arrhythmia. Palpitations indicate an irregular or rapid heart rhythm, and syncope (fainting) can occur when the arrhythmia reduces cardiac output, causing transient cerebral hypoperfusion.
D. History of alcohol drinking:
Chronic or excessive alcohol intake, sometimes called “holiday heart syndrome,” can trigger atrial fibrillation or other arrhythmias. Alcohol affects cardiac conduction and electrolyte balance, increasing the likelihood of rhythm disturbances.
Devon visits the urgent care facility for sudden symptoms of pain to his lower extremity. The initial diagnosis is acute arterial ischemia. Aside from pain, which other symptoms may arise from this diagnosis? Select all that apply.
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Paresthesia
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Pulselessness
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Purulence
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Paralysis
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Pallor
Explanation
The Correct Answers are:
A. Paresthesia, B. Pulselessness, D. Paralysis, and E. Pallor.
Detailed Explanations:
A. Paresthesia:
A tingling or numb sensation occurs due to reduced blood flow and oxygen supply to peripheral nerves, an early sign of ischemia.
B. Pulselessness:
Absent or diminished peripheral pulses indicate a severe reduction or total loss of arterial blood flow, a hallmark sign of acute arterial occlusion.
D. Paralysis:
Muscle weakness or inability to move the affected limb may develop as ischemia progresses and nerve and muscle tissues become deprived of oxygen.
E. Pallor:
The affected limb appears pale or ashen due to lack of arterial perfusion. This can progress to mottling and cyanosis if circulation is not restored.
Lymphedema is characterized by swelling of the extremity. Which of the following symptoms are also presented with lymphedema? Select all that apply.
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Overall lethargy
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Restricted range of motion
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Aching in the affected area
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Cellulitis
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Purulence
Explanation
The Correct Answers are:
B. Restricted range of motion, C. Aching in the affected area, and D. Cellulitis.
B. Restricted range of motion:
As lymphedema progresses, the affected limb becomes heavy, tight, and firm due to fluid buildup and tissue fibrosis. This leads to reduced flexibility and difficulty moving the joint near the swollen area. Over time, chronic swelling can limit function and interfere with daily activities such as walking, dressing, or reaching.
C. Aching in the affected area:
The accumulation of lymph fluid increases pressure within the tissues, resulting in a sensation of aching, heaviness, or discomfort. This pain is typically dull rather than sharp and worsens with prolonged standing, sitting, or lack of limb elevation. The aching is a hallmark symptom reflecting the strain caused by persistent lymphatic congestion.
D. Cellulitis:
Lymphedema compromises local immune defense, making the affected area prone to bacterial infections such as cellulitis. Even minor skin breaks can allow bacteria to enter and multiply within the stagnant lymph fluid. Signs of cellulitis include warmth, redness, tenderness, and sometimes fever, requiring prompt antibiotic treatment to prevent worsening or recurrence.
Mrs. Prentiss is diagnosed with symptomatic AAA. The initial treatment is aggressive blood pressure control. At which of the following readings should mean arterial pressure be maintained?
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Between 80 and 100 mm Hg.
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Between 60 and 70 mm Hg.
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Between 90 and 120 mm Hg.
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Between 100 and 120 mm Hg.
Explanation
The Correct Answer is:
A. Between 80 and 100 mm Hg.
Detailed Explanation:
For patients with symptomatic abdominal aortic aneurysm (AAA), careful blood pressure control is critical to reduce aortic wall stress and prevent rupture. The mean arterial pressure (MAP) should be maintained between 80 and 100 mm Hg to ensure adequate organ perfusion while minimizing pressure on the aneurysm wall. Lower pressures (60–70 mm Hg) risk inadequate perfusion to vital organs, while higher levels (above 100 mm Hg) increase the chance of aneurysm expansion or rupture. Continuous arterial monitoring and IV antihypertensives, such as nicardipine or esmolol, are typically used to maintain this range safely.
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